PCT Performance Ratings: Re-Organisation Is Bad For Your Health

Main Category: Primary Care / General Practice
Article Date: 22 Oct 2007 - 3:00 PDT

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The Healthcare Commission's announcement of NHS performance ratings for 2006/07 confirms the view of many frontline staff. Re-organisation is bad for your health.

The Commission's report emphasises distinct differences in both quality of services and use of resources between those PCTs that were re-organised last year and those that were not. It is not surprising that most of those in the first group have scored 'fair' or 'weak'. Should any future government ever consider a similar re-organisation, they should read this report first.

There is also a fundamental problem for PCTs in that they are scored on achieving national targets such as Choose and Book where they are not responsible for delivery. The Commission acknowledges there have been technical difficulties with the system, while it is GPs - not PCTs - who deliver the scheme. Opinions remain divided as to its value among clinicians and patients.

Despite these problems, it is pleasing to see some impressive successes, such as Barking and Dagenham PCT who have jumped from a 'fair' to an 'excellent' rating for use of resources in just one year.

NHS Alliance chairman Dr Michael Dixon said:

"Primary care trusts have a particularly complex task that needs to be better understood than is currently the case. Their services depend upon the performance of other organisations, ranging from foundation trusts to independent treatment centres to individual GP practices. Depending upon the PCT size, there may be 50 or more different organisations that contribute to their performance rating. Nor can PCT management rely on issuing directions to staff in the same way as the other sectors. Frontline staff are often not employed by the PCT.

"Success in PCTs requires a quite different approach from senior management and Boards. Skills in negotiating and persuasion, and genuine engagement with clinicians, are critical in primary care. It would be useful if, in future, the Healthcare Commission could look at clinician engagement in particular as part of its performance rating of PCTs."

1. The NHS Alliance is the independent body that represents primary care. Its membership includes PCTs, GP practices and other primary care organisations, alongside individual clinicians, managers and non-executives. Its multi-professional base means it is the only organisation that can bring PCTs and practices together. It has twelve active professional networks for PEC chairs, practice based commissioners, senior managers and non-executives, and more.

http://www.nhsalliance.org

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